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Caffeine and Prophylactic Noradrenaline Requirement During Cesarean Delivery

2026年6月12日 更新者:Mina Adolf Helmy、Cairo University

Effect of Preoperative Oral Caffeine on Prophylactic Noradrenaline Requirement During Cesarean Delivery: A Double-blind Placebo-controlled Trial

Spinal anesthesia is the preferred regional technique in obstetric practice because it provides high maternal satisfaction and eliminates the need for airway manipulation. Despite these advantages, it is frequently complicated by spinal anesthesia-induced hypotension , defined as a reduction in systolic blood pressure of more than 20% from baseline or an absolute SBP below 100 mmHg. Spinal hypotension can have serious consequences, including maternal hypoperfusion that may lead to neurological or renal dysfunction, as well as fetal acidosis and bradycardia, which can compromise neonatal outcomes. The present study aims to evaluate the effect of preoperative caffeine administration on noradrenaline requirements during spinal anesthesia in obstetric patients. Specifically, the objectives are to compare noradrenaline requirements between the study groups and to assess the incidence of hypotension in both groups.

研究概览

详细说明

Spinal anesthesia is considered the technique of choice in obstetric practice because it provides excellent maternal comfort and avoids the risks associated with airway manipulation during general anesthesia. Nevertheless, its use is often complicated by a significant drop in blood pressure, which can reduce blood flow to vital organs and impair maternal brain and kidney function. More importantly, decreased uteroplacental perfusion may compromise fetal oxygenation, leading to acidosis and slowing of the heart rate, both of which can negatively affect neonatal outcomes. These risks make it essential to explore preventive strategies that can stabilize blood pressure during spinal anesthesia. Caffeine, a widely available and inexpensive stimulant, enhances sympathetic nervous system activity and may counteract the vasodilation that contributes to low blood pressure. This study therefore investigates whether giving caffeine before anesthesia can reduce the need for noradrenaline, a commonly used vasopressor, and whether it can lower the incidence of hypotension. By examining these outcomes, the research aims to determine if caffeine could serve as a simple intervention to improve both maternal safety and neonatal wellbeing.

研究类型

介入性

注册 (估计的)

62

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习联系方式

学习地点

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人

接受健康志愿者

不

描述

Inclusion Criteria:

  • Full-term singleton pregnant (>37 weeks)
  • ASA II
  • undergoing elective cesarean section.

Exclusion Criteria:

  • Patient refusal
  • SBP < 100 mmHg
  • Allergy to local anesthetics or caffeine
  • Coagulopathy (INR>1.4 or platelets <75.000)
  • Preeclampsia

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:预防
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:四人间

武器和干预

参与者组/臂
干预/治疗
有源比较器:Caffeine
30 minutes before spinal anesthesia in the preoperative area, the patient will receive 200 mg caffeine capsule
Patients will receive 200 mg oral caffeine 30 minutes before spinal anesthesia
安慰剂比较:Control
30 minutes before spinal anesthesia in the preoperative area, the patient will receive placebo
Patient will receive placebo capsule

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Average noradrenaline requirement
大体时间:After spinal anesthesia till delivery
The total noradrenaline administered as an infusion plus boluses divided by patient weight and infusion time.
After spinal anesthesia till delivery

次要结果测量

结果测量
措施说明
大体时间
Incidence of spinal hypotension
大体时间:After spinal anesthesia till end of delivery
Reduction of systolic blood pressure more than 20% of baseline
After spinal anesthesia till end of delivery
Time to first hypotensive episode
大体时间:After spinal anesthesia till delivery of the baby
Time to develop the first hypotensive episode in minutes
After spinal anesthesia till delivery of the baby
APGAR score
大体时间:at 10 minutes of delivery
Assessment of APGAR score of neonates
at 10 minutes of delivery

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年6月16日

初级完成 (估计的)

2026年9月16日

研究完成 (估计的)

2026年9月19日

研究注册日期

首次提交

2026年6月12日

首先提交符合 QC 标准的

2026年6月12日

首次发布 (实际的)

2026年6月17日

研究记录更新

最后更新发布 (实际的)

2026年6月17日

上次提交的符合 QC 标准的更新

2026年6月12日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

未定

IPD 计划说明

At present, we have not finalized a plan for sharing individual participant data. Decisions regarding data sharing will depend on factors such as ethical approval, participant consent, and institutional policies. If sharing becomes feasible, de-identified data may be made available upon reasonable request following appropriate review.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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